Abstract:

Objective To evaluate the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the treatment of elevated colorectal lesions and analyze the risk factors for the local recurrence after EMR in order to improve the indications of EMR and ESD treatments. Methods The clinical and surgical data of 427 patients (with 606 colorectal lesions) undergoing EMR and 70 patients (with 80 colorectal lesions) undergoing ESD were retrospectively summarized. The clinical and surgical data of 145 patients undergoing EMR and 30 patients undergoing ESD obtained from follow-up visits were analyzed. The complications and local recurrence rates of two groups were compared and the risk factors for the local recurrence in the EMR group were analyzed. Results The rates of surgical complications in the ESD group and the EMR group were 7.14% (5/70) and 2.58% (11/427), respectively. There was no statistical difference in the rate of complications such as perforation and massive hemorrhage between two groups (P=0.06). The local recurrence rate of the EMR group was 22.76% (33/145), which was significantly higher than 3.33% (1/30) of the ESD group (P<0.05). The multiple factor analysis showed that multiple colorectal lesions were the risk factor for the local recurrence after EMR. Conclusion The rate of complications of ESD is higher than that of EMR with more complete resection of lesions and lower local recurrence rate. For patients with multiple colorectal lesions, close follow-up is required after EMR.

Key words: endoscopic mucosal resection(EMR), endoscopic submucosal dissection (ESD), elevated colorectal lesions